Provider Demographics
NPI:1972373553
Name:PUZIE, DANISHIA
Entity type:Individual
Prefix:
First Name:DANISHIA
Middle Name:
Last Name:PUZIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 FOREMOST AVE NW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-2839
Mailing Address - Country:US
Mailing Address - Phone:321-442-5312
Mailing Address - Fax:
Practice Address - Street 1:298 FOREMOST AVE NW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2839
Practice Address - Country:US
Practice Address - Phone:904-994-7041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
385H00000X
FL376J00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care
No372600000XNursing Service Related ProvidersAdult Companion